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Cost effective computerized psychological testing especially for hospitals Benefits | Tests | Contact Us | Adult Test Sample | Juvenile Test Sample | Child Test Sample PsychScreen Hospital Edition Adult Sample Ages: Adults 18+ Tests available for use in Adult reports
REPORT CONTENTS INTELLECTUAL FUNCTIONING Vocabulary, verbal abstraction, visual problem solving, Organicity, Learning Disorder, concentrational problems, cognitive rigidity/flexibility, personality effects on cognitive style, rate of thought, obsessive ruminations, mental confusion/psychosis, delusional content VALIDITY OF TEST RESULTS Disclosiveness, symptom minimisation, symptom exaggeration, consistency, response sets PERCEIVED LIFE STRESS, RESOURCES AND SUPPORT EMOTIONAL FUNCTIONING Levels of depression/dsythymia, anxiety, anger experience and control, repression/emotional control, impulsivity, energy level ALCOHOL AND DRUG USE Reported use, obvious and subtle characteristics, ACOA issues and social system use SOMATIC FUNCTIONING Level of somatic concerns, hypochondriasis, conversion, and somatization INTERPERSONAL FUNCTIONING Social skills, introversion/extroversion, social comfort, need for attention, need for love, independence/dependence, dominance/passivity, empathy, trust, vigilance, criticalness, family problems, school/work attitudes and behaviours SELF IMAGE Ego strength, self esteem, self image PERSONALITY FUNCTIONING Primary and secondary personality patterns IRRESPONSIBLE THINKING ERRORS CRIMINAL CHARACTERISTICS Generalised delinquent tendencies, awareness of appropriate social expectations and norms, criminal attitudes/values, social maturity, authority conflicts, criminal motivations CRIMINAL MOTIVATIONS RISK/NEEDS ASSESSMENT Standard LSI-R cutoffs for placement, LSI-R subcomponent analysis of specific need areas NORMAL SEXUAL FUNCTIONING Sex drive, levels of sexual fantasy, fund of sexual information gender identity, is strongly discrepant and does not match stereotyped images of his gender. Body image, overall sexual satisfaction DEVIANT SEXUAL FUNCTIONING Normal sexual drives, sexual preoccupation, fund of sexual knowledge cognitive distortions and immaturity typically found among sex offenders, justification, rationalization, pathology similar to that found among child molesters, Rape behaviour, exhibitionistic pathology, paraphilias, sexual dysfunctions/disabilities, motivation to seek treatment for sexual problems. PRIMARY CRIMINAL RELAPSE TRIGGERS IDENTIFIED RISK FACTORS FACTORS MITIGATING RISK DIAGNOSTIC CONSIDERATIONS TREATMENT RECOMMENDATIONS Name: Adult Sample Age: 32 Sex: M Referred By: YOU Interpret Date: 11/24/99 Test Date: 11/24/99 PSYCH SCREEN INC. PHONE (800) 588-9412 FAX (608) 752-4314 HOSPITAL EDITION REPORT -- ADULT To aid in diagnosis and treatment planning, Mr. Sample was administered a battery of psychological tests including the Shipley Institute of Living Scale, Matrix Reasoning subtest of the WAIS - III, Minnesota Multiphasic Personality Inventory-2, Millon Clinical Multiaxial Inventory - III, SASSI-3, State-Trait Anger Expression Inventory, Jesness Inventory, and Derogatis Sexual Functioning Inventory. The following test findings are based on Mr. Sample's responses to a widely used standardized psychological test. As with all such tests, the validity of test results is limited by Mr. Sample's honesty and self-awareness. The report below should be taken as generalized probability statements that are made without benefit of clinical interview or history. Further clinical verification is needed to assist in the interpretation of test findings in light of Mr. Sample's unique history and present circumstances. Since the MMPI-2 is a complicated test with multiple scales that measure similar constructs, at times inconsistencies in test results may occur due to Mr. Sample's different elevations on similar scales. When this occurs, clinical investigation to evaluate his true status is suggested. As psychological tests were designed primarily for Diagnosis and Treatment Planning purposes, the findings below focus on problems, deficits and pathology and de-emphasise Mr. Sample's strengths. Because of this, use without collaboration, other than for the Clinical screening purpose for which they are intended, may be misleading. The following is a CONFIDENTIAL REPORT meant for qualified Mental Health, Correctional and Substance Abuse professionals. While feedback of test findings to clients is highly encouraged and should be an integral part of therapy and treatment planning, clients should not be given copies of this report as they are probable to misunderstand report contents and their tentative nature. INTELLECTUAL FUNCTIONING: Mr. Sample's potential intellectual functioning is in the Average range as testing indicates normal functioning. Verbal abstract reasoning is in the Normal Range with him displaying an Average ability to think in terms of general principles, solve logical problems and generalize between situations. Mr. Sample's Borderline Retarded vocabulary denotes problems with learning ability, lack of motivation or poor environmental stimulation. Expressive and receptive language difficulties may exist. Given Mr. Sample's verbal abstraction, his relatively poor vocabulary suggests a Learning Disorder that may need evaluation if motivational and environmental causes do not exist. Significant levels of emotional upset are reported which may interfere with memory, concentration, abstraction and judgment. In a test of visual abstract reasoning, Mr. Sample scored in the Average range indicating normal visual problem solving. Both visual and verbal abstract reasoning capacity were similar. Severe difficulties in vocabulary in comparison to Mr. Sample's visual abstract reasoning exist. This may indicate Organicity, Expressive Aphasia or learning problems that should be taken into account in diagnosis and treatment planning. Mr. Sample is not reflective or thoughtful which can limit insight and judgment. He does not try to understand the world in cognitive, rational ways. A good deal of verbal facility is likely. Concentration difficulties are probable with Mr. Sample being distractible, preoccupied, and inattentive. This may cause Mr. Sample to miss important environmental cues leading to decreased judgment and coping. Mr. Sample is likely to be concrete in his thinking due to personality factors despite his potential level of intellectual functioning as personality factors predispose Mr. Sample to overly focus on detail and miss general trends. Mr. Sample likes clear-cut situations and has trouble dealing with ambiguity, novelty and change. He is an extremely cognitively rigid individual who has fixed ideas from which he has trouble deviating. Mr. Sample may fail to take in additional information or alter his opinion once an idea is formed. Poor judgment and situational misperceptions can result from reacting in terms of these fixed beliefs without seeing if they match the current situation. At this level, delusional ideation may occur. Mr. Sample is likely to be ambivalent to the point where problem solving and judgment are adversely effected. He reports having an overly flexible cognitive style with him often changing his mind, being indecisive, and easily being swayed by others. Due to a lack of self-confidence, Mr. Sample may be indecisive and have problems with decision-making. Mr. Sample may at times show poor planning as he is moderately cognitively impulsive. He does not usually weigh alternatives and can act without needed cognitive mediation or planning. Due to his cognitive style, Mr. Sample may have problems learning from experience and can repeatedly make similar mistakes. Moderate levels of racing thoughts and flight of ideas may be occurring. Severe obsessive ruminations and worries are reported that are very likely to disrupt Mr. Sample's cognitive efficiency. Levels of brooding over problems exist to the point where he may lose control of his thought processes. Mr. Sample reports feeling somewhat mentally dull as he reports experiencing increased cognitive inefficiency. Schizotypal features were not present. Thinking is goal-directed and orderly without significant mental confusion. Unusual thoughts and sensory experiences are not reported. Mr. Sample does not report having ego-alien ideas that distress him. VALIDITY OF TEST RESULTS: VALIDITY OF TESTS OF PSYCHOPATHOLOGY: In completing the MMPI-2, Mr. Sample answered almost all test questions. In testing, Mr. Sample did not appear to defensively deny having common human faults and weaknesses and was willing to indicate his shortcomings. Mr. Sample did not attempt to cover up and minimize problems. This may indicate openness or may be a result of limited ego strength or a poor self-concept. Mr. Sample appears to have moderately focused on and over emphasized pathology/problems, presenting himself in an unrealistically negative light. This "fake bad" response set may affect the validity of the following test findings, as the test results given below are probably an exaggerated or distorted overstatement of Mr. Sample's true symptoms/problems. Such a response set could be due to poor reading ability, mental confusion, chronic atypical thought patterns, compulsive attempts to be frank and/or a cry for help, though conscious malingering needs to be ruled out as a cause for symptom exaggeration. Mr. Sample mildly over emphasized pathology in later portions of the MMPI-2, which would primarily increase Content and Supplementary scales. Mr. Sample was consistent in answering test questions similarly throughout the test which enhances the probable validity of the test findings given below. VALIDITY OF PERSONALITY TEST RESULTS: Mr. Sample appeared to have read the tests and did not respond randomly. He was so unusually open in answering test questions that this may result in an over reporting of symptoms with test findings being a significant magnification of his true problems. A moderate "fake bad" response set exists in which Mr. Sample exaggerated problems. This may affect the validity of the following test findings, as test results are probably an exaggerated, distorted overstatement of Mr. Sample's symptoms/problems. VALIDITY OF SUBSTANCE USE TESTS: Mr. Sample did not appear to have randomly answered questions about his substance use. Mr. Sample had a generalized tendency to be overly disclosive in answering questions. As a result, the following findings are probable to be an over representation of his pattern of substance use. Supplemental addiction measures show significant defensiveness in responding to use-related items. EMOTIONAL FUNCTIONING: In testing, Mr. Sample reports average levels of depression. Clinical symptoms of Depression are unlikely unless severe repression and denial exist that limit his experience of subjective discomfort. Mr. Sample does not report being dysphoric or ahedonic. Many physical symptoms/signs of depression are endorsed which suggest a Major Depression. A preoccupation with his physical state may also exist as Mr. Sample denies good health and makes a wide variety of somatic complaints. Subtle indicators of depression were in line with obvious indicators confirming the validity of the findings. Mr. Sample's level of true depression is in line with what he subjectively experiences without minimizing or focusing on feelings. Moderate subjective depression is noted with Mr. Sample being despondent. A mild chronic Dysthymic, "poor me" Victim stance exists where Mr. Sample is overly pessimistic, negative, and adopts a martyr-like role. He may be very pessimistic and make many negative self-statements. Such severe levels of anxiety are reported that Generalized Anxiety Disorder, Panic Attacks, Phobias, ADHD, Mania and PTSD need to be clinically ruled out. Mr. Sample reports being so nervous that he has trouble dealing with everyday stress, pressure, and demands. He easily feels panicky, distraught, and vulnerable due to over evaluating objective danger as Mr. Sample feels threatened by people or events commonly seen as of little or no concern. Mr. Sample is an over-ruminative worrier. Physical symptoms due to autonomic over-arousal can exist. Levels of anxiety reported are probable to interfere with coping skills, increase impulsivity and lead to aversive consequences that produce more anxiety. Mr. Sample's anxiety is in line with his subjective experience. Mr. Sample reports subjectively experiencing severe levels of anxiety and nervousness. Testing shows significant phobias and/or tendencies to develop phobias. A high level of generalized fear is reported that may constrict Mr. Sample's behavior. He tends to be easily scared and is fearful in many situations. Mr. Sample is very phobic with multiple specific fears reported that may lead to avoidance behavior. Severe Post Traumatic Stress Disorder symptoms are endorsed. Answers to obvious measures of anger/antisocial tendencies were higher than subtle measures. Mr. Sample may be trying to project an image different from his true self and may be less aggressive than testing indicates. He very strongly endorsed obvious anger and antisocial tendency items, but also endorsed moderate levels of subtle anger and antisocial behavior items. At present, Mr. Sample reports experiencing mild overall anger. Very strong subjective angry feelings are currently admitted to. Mr. Sample is now experiencing moderately above average pressures to be verbally aggressive. Average pressures to physically express anger are currently said to exist. Thus both subjective angry feelings and pressures to verbally, but not physically, act out in an angry manner exist. Present pressures to verbally express anger are significantly more than pressures to physically express anger. Chances of aggressive behavior are reduced by at least average overall EFFORTS to monitor and control the outward expression of anger. Because he makes few efforts to reduce and calm down once angry feelings are experienced, the danger of present aggression is further increased. Additionally, present aggressive behavior is significantly more likely as he admits to strong overall tendencies to act out on anger once experienced. Present levels of anger reflect longstanding anger problems. Very high levels of Trait Anger are admitted to as Mr. Sample described himself as generally experiencing severe levels of anger. He does not describe himself as being quick tempered. Mr. Sample is overly sensitive to criticism and rejection and so may perceive/exaggerate criticism and rejection where none actually exists. Feelings of rejection can provoke intense anger that may lead to further rejection. Mr. Sample reports very frequently experiencing high levels of anger in a variety of settings. His subjective experience of anger can be intense and serve as a focal point for determining behavior. How this anger is expressed depends on the anger management style described below. Once anger is consciously experienced, Mr. Sample reports making normal efforts to suppress his anger. Mr. Sample then invests little energy in calming down and remaining conscious anger. He usually experiences anger once angry feelings are evoked. Mr. Sample describes making moderate efforts to control rather than act out on anger when it is consciously experienced. Severe tendencies to act out on anger once consciously experienced are said to exist. Feelings may be expressed either verbally or behaviorally. Mr. Sample does not display tendencies to be Authoritarian and does not use his anger to intimidate others. While significant efforts to suppress, repress and/or deny anger are reported, Mr. Sample directly expresses anger once he becomes aware of it. Mr. Sample's tendency to act out on anger once it is felt is likely to be expressed as significant irritability, high levels of Trait anger and/or generalized tendencies to experience anger are reported. Level of antisocial traits found suggests that Mr. Sample may lack emotional depth. However, he can experience scattered and well rationalized anger and resentment. He is not prone to guilt, worry or remorse. He has average tendencies to consciously repress feelings once they are experienced. Admitted levels of repression were similar for both subtle and obvious items. When feelings are experienced, Mr. Sample tends to suppress them. He can be over controlled, objective, and detached from his feelings to the point where he may also have difficulty expressing warmth and other positive feelings. Mr. Sample can accept and deal with his own feelings and does not see them as strange or foreign to himself. Impulse control is poor with Mr. Sample impulsively acting out directly on feelings to gain immediate gratification with little forethought of consequences or alternate courses of action. Impulsivity may lead to self-defeating behavior. Mr. Sample does not subjectively feel out of control of his impulses and is not concerned acting out on them. Mr. Sample's reported energy level is significantly raised with him being an action-oriented, sensation-seeking individual who acts out when bored. Periodic hyperactivity, labile affect and poor self-control are probable. Fearlessness and increased energy may lead to poor judgment and reckless behavior. Further testing may be needed to rule out Mania or Attention Deficit Hyperactivity Disorder if symptoms are not due to substance use. Mr. Sample's subjective drive and ambition level is normal and should not interfere with engaging in activities or completing tasks. He reports normal levels of excitement and restlessness. Moderate psychomotor hyperactivity is reported with heightened speech, thought, and motor activity possible. Psychomotor acceleration is possible. Obvious indicators of mania were more apparent than subtle indicators. Above average amounts of Manic symptoms were described in obvious items with average Manic symptoms reported on subtle, less face valid Mania items. ALCOHOL AND DRUG USE: The MMPI-2 reveals significant addiction proneness and possible substance use. Mr. Sample tends to be extroverted, sensation-seeking, and impulsive which may lead to acting out behavior including substance use. Further evaluation for possible alcohol and drug use is indicated. Severe characteristics similar to those found among individuals who are alcohol-dependent are reported in the MCMI. Mr. Sample expresses a preference for alcohol over drug use. The above findings need to be taken in conjunction with the SASSI results given below, as the SASSI was designed to detect addiction even in resistive clients. Potentially addictive levels of alcohol use and alcohol-related symptoms are admitted to on face valid measures. Face valid measures do not indicate addictive levels of drug use and drug-related symptoms. A preference for alcohol over drug use is described by Mr. Sample. Above average levels of Obvious Attributes typical of chemically dependent individuals exist as Mr. Sample admits to many personality traits empirically found among substance dependent individuals. Subtle Attributes empirically found among chemically dependent individuals were not apparent in testing. Mr. Sample reports having been involved in a family or social system where severe levels of substance use have occurred. Test scores indicate an average level of similarity to alcoholic family members. Mr. Sample is largely being able to focus on his needs and set proper boundaries. The level of defensiveness found on specialized measures of substance use denial along with moderate admissions of substance use on face valid measures indicate probable addiction. Despite his level of reported substance use, Mr. Sample's level of involvement in social systems where extensive substance use exists indicate a high chance of addiction. Signs of substance dependence exist which require professional intervention. If needed, moderate duration treatment is indicated due to moderate levels of underlying addictive tendencies found in testing. SOMATIC FUNCTIONING: Current somatic concerns on a wide variety of physical problems are reported which may indicate an over concern about his physical condition. GI symptoms are not reported by Mr. Sample in testing. Significant neurological problems were described. Problems with physical symptoms that may be organic are not reported. Mild to moderate hypochondriacal complaints, often without a clear organic basis, are probable as Mr. Sample reports numerous physical symptoms. A history of vague physical signs and a preoccupation with bodily functioning is probable. Mr. Sample's symptoms may in part be stress-related as he overly focuses on minor illnesses which causes more concern than would be expected. He does not now feel below par either mentally and physically. No significant tendencies for psychosomatic problems to develop under stress exist. Mr. Sample does not usually use physical symptoms for secondary gain such as to avoid responsibility. Conversion symptoms due to repression are possible, but not probable. Current severe levels of stresses and/or stress proneness can cause real stress-related somatic complaints to develop including cardiovascular and gastric symptoms despite Mr. Sample's tendencies not to somatize. INTERPERSONAL FUNCTIONING: Mr. Sample is a mildly eccentric individual who may be lacking in social skills. His unusual behaviors and thought patterns can make it hard for others to relate to him. Mr. Sample is an introverted individual who tends to be more comfortable when alone. An attachment deficit may exist as Mr. Sample describes engaging in significant avoidance and interpersonal withdrawal. He at times withdraws and tries not to be with others. A significant level of social discomfort and anxiety is reported. Mr. Sample feels confident in social situations. He questions his ability to effectively deal with and relate to others. Mr. Sample's self-centeredness and/or grandiosity moderately limits his sense of empathy. He can be critical of others as he lacks fear of alienating people and causing confrontation. Extreme needs for love and affection exist where Mr. Sample does almost anything to receive love. Such needs may be extremely difficult to fill resulting in a high level of frustration. Codependent relationships are probable. Mr. Sample's level of suspiciousness and/or social withdraw may interfere with Mr. Sample's ability to meet his needs for love. Mr. Sample is a dominant, persistent individual who likes to take the lead in situations. He may have difficulty following others. Mr. Sample voices an extreme need to be dependent on others. Codependency issues are paramount. Mr. Sample is somewhat interpersonally sensitive which makes it difficult for him to develop rapport and intimacy. He easily can feel estranged, different and unusual. He feels misunderstood by others. Mr. Sample is very sensitive to and vigilant of others. Mr. Sample is a severely suspicious and distrustful individual who blames others for his problems. He often over reacts to social situations, as he is overly vigilant and easily feels taken advantage of. This lack of trust leaves Mr. Sample interpersonally guarded, touchy and argumentative. Higher scores on obvious measures of interpersonal distrust and suspiciousness were found with Mr. Sample being open about his feelings. While severe obvious paranoia items were endorsed, he at the same time described below average levels of subtle paranoia items. Mr. Sample projects blame for his problems, sees the world as threatening, and feels that he is unfairly treated. Marked feelings of prosecution are probable. He sees others as very untrustworthy and devious. He feels others will act to their own ends without considering his needs. Mr. Sample can be overly judgmental and critical. He is a very self-righteous, moralistic, individual who feels that he lives up to high ethical standards. Mr. Sample often has hostile feelings when others do not live up to his standards. He may ignore social rules and do what he pleases. The significant antisocial trends reported suggest that Mr. Sample wants to do as he pleases without feeling a sense of obligation to others. He has trouble with authority and resents rules. Power and control issues are probable. Verbal threats and aggression may be used to gain other's compliance. Mr. Sample's relationships tend to be stormy and conflictual. He has difficulty maintaining a long-term relationship. Multiple family problems are reported with Mr. Sample feeling exceptionally unloved and unsupported by his family. Dysfunctional, conflictual relationships and severe anger are probable. Severe marital problems are reported with his marriage being extremely conflictual and a major source of stress. Mr. Sample reports having unproductive work attitudes and behaviors that may interfere with work performance and leave him feeling unable to perform his job. An average focus on work was described with Mr. Sample not seeing himself as overly preoccupied with work. Mr. Sample has mild achievement needs and wants higher economic status. SELF IMAGE: He may have difficulty exhibiting a stable sense of identity and generally feels that he has a below average ability to cope with his world. Mr. Sample reports significant problems tolerating stress and/or effectively dealing with the people and problems in his life and often feels unable to cope with problems. Feelings of self-efficacy are low. Mr. Sample feels an average ability to cope with his problems without withdrawing into fantasy. He is self critical to a normal degree and can focus both on failures and the positives in himself. Mr. Sample has an average sensitivity to what others think of him. He has an extremely poor self-esteem and feels unattractive and useless. Mr. Sample easily feels rejected as he projects his own feelings of being unattractive and useless. Mr. Sample feels very uncomfortable and unhappy with himself. Extreme guilt and regret are reported. Mr. Sample describes himself as having strong characteristics that are stereotypically feminine and denies having masculine features. Mr. Sample's repertoire of behaviors that he is likely to draw on are similar to those of a typical female. Mr. Sample has a grandiose self-image and over rates his importance. Mr. Sample unrealistically appraises his own abilities and feels that he is above others. Mr. Sample tends to deny his most recently held value system and may not act in a responsible manner. In testing, Mr. Sample identifies himself as having strong antisocial values and as having acted out antisocially. He has significant problems with authority and social standards. Mr. Sample feels that his ends justifies any means. He can be dishonest and opportunistic in dealing with others and justify his acts. Much acting out behavior without guilt is likely. Mr. Sample may have rejected a previously held value system and have adopted a new one. He is so rigid about his new beliefs that he cannot tolerate others who have beliefs different from his. His religious beliefs are very fundamentalist and/or conservative. Mr. Sample can be so self-righteous that he may fail to see his faults. DEFENSES:
PERSONALITY FUNCTIONING: Mr. Sample has poor ego strength and lacks a firm sense of self, which can lead to inconsistent, self defeating, situationally determined behavior. Impulsive, disorganized thinking results in poor judgment and reality testing. Intense mood swings can lead to dramatic and unexpected behavioral outbursts. Much interpersonal ambivalence exists with Mr. Sample having stormy relationships that usually are Hostile Dependent. Mr. Sample has an intense dislike of isolation and loneliness and may engage in a series of transient, stormy relationships that are based on alternating idealization and deflation. Manipulative suicide threats, gestures or attempts are probable. Testing indicates marked Paranoid features as he is a suspicious, mistrustful individual with persecutory ideas. Mr. Sample views people as vindictive, sees himself as a victim, has an external locus of control and blames others for his problems. He is on guard, wary, and hyper-vigilant as Mr. Sample looks for evidence of persecution. Moderate Self-Defeating patterns are evident in testing with Mr. Sample having difficulty in accepting and dealing with success. In addition to the above, other significant Basic Personality Patterns were reported by Mr. Sample. Mr. Sample's testing indicates very severe Character pathology. He has deeply ingrained dysfunctional personality patterns that are probable to cause interpersonal and intrapsychic problems. These patterns must be taken into account in diagnosing and treating other psychological problems (Axis I Disorders). Testing indicates significant Dependent, Antisocial, and Passive-Aggressive features that are likely to effect daily functioning. Mr. Sample is a Criminal Thinker who wants others to take care of him and often follows peers into negative behavior to please them. Mr. Sample passive aggressively resists the demands of authorities and does as he pleases. Mr. Sample becomes angry when others do not fulfill his needs, with underlying anxiety often present as well. Mr. Sample is unreliable, rejects obligations, and does not attempt to follow societal norms. Mr. Sample does not directly pursue his needs, avoids external demands and responsibilities, and is not self-reliant. He sets boundaries through passive resistance as he frustrates demands by being inefficient, stubborn, and incompetent. Exaggerated and unnecessary help-seeking behaviors can occur. Relationships tend to be superficial and predatory as he exploits others for his own purposes. Mr. Sample is self-centered and has little empathy or loyalty. Mr. Sample's relationships often are codependent and abusive as his excessive longing for love leads to a need to control people and situations. Mr. Sample projects blame and rationalizes his behaviors, using his ends to justify any means. He focuses on problems without seeing positives, blames others for his difficulties and often believes himself to be harassed and victimized. Pathological lying, deception, insincerity, and disregard for the truth are likely. Mr. Sample's judgment is hampered because he distorts events to fit the way he wishes things were, rather than the way they are. He does not easily learn from experience since he does not believe that his behavior will be punished. Mr. Sample lacks remorse, guilt, and shame. Frustration tolerance is poor; he is a short-tempered, aggressive individual who acts out impulsively. Depression, negativity, resentment, and anger coexist because Mr. Sample believes that he "got a raw deal from life." Underlying worry and anger can result in mood swings and tantrums. Emotional reactions are especially likely evoked when issues of abandonment are present. Mr. Sample's criminal behavior is most often based on active Criminal Thinking, underlying dependency needs, or rebelliousness. MMPI-2 RESULTS INDICATE THAT IN ADDITION TO THE ABOVE PERSONALITY PATTERNS, Mr. Sample also IS: Mr. Sample is a perfectionistic, overly conscientious individual who is afraid of making mistakes and not living up to his standards. Because Mr. Sample has poor self-esteem and fears failure, he wants others to take care of him and so tries to please people by following set patterns of thought, feeling and action. He can be demanding, inflexible, and have difficulty departing from his habitual patterns. Mr. Sample feels strong anger and anxiety when he does not receive the support or recognition that he believes he deserves or when others do not live up to his standards. Mr. Sample's fear of making mistakes results in indecision and an obsession with doing things the right way. Out of fear of failure, Mr. Sample avoids responsibilities, is not self-reliant and can make exaggerated and unnecessary appeals for help. Racing thoughts, cognitive rituals, preoccupation, and "black or white" dichotomous thinking are probable. Mr. Sample can be focus so closely on details that he often "can't see the forest for the trees." His attention is rigid and narrow with him having an inordinate need for closure. While Mr. Sample is largely unaware of his feelings out of fear that negative emotions will cause rejection, he is anxiety prone and often emotionally over reacts to situations out of fear of failure. Underlying worry and anger can result in mood swings and tantrums. Occasional intense righteous indignation occurs when others do not live up to his standards. Mr. Sample applies similar standards to himself and can suffer from guilt. He is anxious about possible humiliation, as he fears being found inadequate. Emotional reactions are especially likely when issues of separation or abandonment are present. SECONDARY MMPI-2 SCALE ELEVATIONS FURTHER SUGGEST THAT Mr. Sample is: Has poor frustration tolerance and acts for immediate gratification without thought of consequences or social appropriateness. Mr. Sample can be self-centered and engage in impulsive acting out behavior without planning. At times Mr. Sample disregards rules and behaves in an irresponsible, hedonistic self-indulgent manner. <Her/She> can have difficulty profiting from his experiences, both good and bad. Anger may be used to manipulate others. Little anxiety or remorse is experienced by Mr. Sample. Is interpersonally mistrustful, sensitive and blaming. Mr. Sample can be rigid, self-righteous, and grandiose. He is interpersonally suspicious, sensitive to what others think of him and may see others as being critical of and against him. He can become dissatisfied and feel that he is not getting what he deserves. Is an action-oriented, high energy individual who may become grandiose. Mr. Sample can be expansive, grandiose, and unrealistically optimistic. He often makes plans that he does not follow through with. Mr. Sample dislikes routine and easily becomes bored. This can lead to inconsistent, self-defeating behavior. He is mildly self-centered which can interfere with the formation of lasting relationships. Is introverted, interpersonally aloof, shy and easily embarrassed in social situations. CRIMINAL CHARACTERISTICS: Mr. Sample's overall score on a Discriminant Function analysis shows mild to moderate generalized delinquent tendencies. He has moderate underlying global predisposition to break social rules and act out antisocially. Mr. Sample's testing suggests moderate problems with his knowledge and acceptance of common social rules. He may act in ways that are not socially acceptable. He does not have a value system typical of criminal populations. Mr. Sample is an extremely socially immature, irresponsible individual whose coping skills and social judgment are poorly developed. He unrealistically evaluates and inappropriately deals with problems. He tends to lack in insight and empathy, with little awareness of how his behavior impacts others. Mr. Sample's feelings are often repressed and can cause acting out when experienced. Mr. Sample tends to be mistrustful and has trouble relating with authority figures whom he typically views as being unfair and untrustworthy. Hostility occurs when Mr. Sample feels that others are attempting to control him. Mr. Sample views the world in terms of power and control and attempts to manipulate others to his own ends. Manipulation and deceit can become a way of life and are ends in himself. Mr. Sample's conscience development is lacking as he purposely attempts to deceive and manipulate others in his efforts to control them. Testing also shows Mr. Sample has other secondary motivation(s) for acting out including: Mr. Sample conformity to peer group values can also lead to acting out as he does not see his behavior as maladaptive because it gains peer-acceptance. Mr. Sample is more likely to follow others into crime than instigate criminal acts by himself. Mr. Sample has a strong negative self-image that leads him to ruminate on his problems. Tension builds until he acts out to relieve repressed feelings. Criminal behavior is often a way to deal with underlying emotional problems. Mr. Sample is a highly negative, distrustful individual who acts out on underlying emotional problems. His emotional conflicts often center on unmet dependency needs. Mr. Sample is reluctant to let others get close out of fear that they will control or reject him; at the same time, he desires acceptance. This internal conflict can lead to erratic acting out. SEXUAL FUNCTIONING: Mr. Sample described having a low average sex drive with him desiring sex to a somewhat less than normal degree. He admits to having participated in an exceptionally limited range of sexual behaviors and practices as compared to others, which may indicate substantial sexual inhibition, rigidity, or lack of interest. Low average levels of sexual fantasy are reported. Expressed attitudes toward sex were extremely conservative, traditional and restrictive. An exceptional number of sexual taboos were reported. Mr. Sample's fund of sexual information is in the lower end of the average range. He at times may lack knowledge about sex and sexual functioning. His identity does not match stereotyped images of his gender as Mr. Sample described himself as having somewhat more characteristics commonly associated with the opposite gender. This may indicate a degree of androgyny and flexibility in sex role. Mr. Sample has an extremely poor body image and feels very dissatisfied with his body and appearance. He feels that he is very unattractive which may significantly influence his behavior. An extremely low level of overall satisfaction with his sex life is reported. IDENTIFIED RISK FACTORS:
VERY SEVERE CHARACTER PATHOLOGY:
MILD TO MODERATE CHARACTER PATHOLOGY:
FACTORS MITIGATING RISK:
DIAGNOSTIC CONSIDERATIONS: RULE OUT AXIS I:
AXIS II:
TREATMENT RECOMMENDATIONS: Based on Mr. Sample's self-report, the following corrective treatment approaches are recommended. Care should be taken to ensure that these suggestions match Mr. Sample's clinical presentation and history. If test invalidity indicators have been raised (see validity section), these recommendations may not reflect Mr. Sample's true clinical needs. DUE TO SIGNIFICANT LEVELS OF AGGRESSION REPORTED, CLINICAL INVESTIGATION OF POSSIBLE HOMICIDAL IDEATION SHOULD OCCUR WITH NECESSARY INTERVENTIONS TAKEN. PSYCHIATRIC REFERRAL FOR EVALUATION FOR PSYCHOTROPIC MEDICATIONS IS WARRANTED INCLUDING THE FOLLOWING TYPE(S) OF MEDICATION FOR: ANTIANXIETY ANTIANGER Due to possible learning problems, much redundancy and multisensory input should be used. Care needs to be taken so that Mr. Sample's treatment does not become a failure experience due to his learning problems. Self-esteem issues over learning deficits should be addressed in therapy. As it is likely that Mr. Sample's emotions are interfering with his cognitive processing, immediate interventions to alleviate emotional distress are suggested. Exploration of the causes of verbal problems as compared to visual functioning should be investigated. Presentation of material in a visual format should be effective. Behavioral techniques such as discrete target behaviors and immediate consequences are suggested to teach Mr. Sample to take responsibility for his actions as he does not connect actions with his consequences. Need for consistency and clarity is all important with Mr. Sample not allowed to talk his way out of consequences. Rationalizing and intellectualizing must be challenged as Mr. Sample needs to learn that what he does is much more important than his reasons and intentions. Mr. Sample's attempts to dominate and control are prime therapeutic issues. Mr. Sample must develop faith in his ability to cope with situations over which he has little control and gain insight into the historical causes of his power and control issues. Power struggles are to be avoided with consequences given in a matter-of-fact way. Therapists should not accept excuses and rationalizations as Mr. Sample needs to realize that his rebelliousness and "yes but" behavior is self-defeating. Underlying issues of anger and control must be brought directly to the surface and dealt with. Use of praise and positive reinforcement is particularly useful as Mr. Sample is more likely to change his behaviors in order to receive praise than he would be to avoid punishment. Unless negative feedback is couched in carefrontational ways, Mr. Sample will ignore and discount it as criticism. A Social Learning component is suggested as Mr. Sample must learn positive, prosocial skills to replace current maladaptive patterns. Mr. Sample now relies on maladaptive tactics to meet his needs with him having few alternative prosocial coping skills. Referral for education, volunteer work, job training, etc. should occur once Mr. Sample develops the social and cognitive skills necessary to be successful. Extensive value adjustment work is necessary as Mr. Sample lacks knowledge of normal societal conventions. He must be taught what acceptable social standards are through educational and Cognitive Behavioral approaches. Mr. Sample is more likely to initially profit from individual rather than group therapy as he lacks social skills and is so afraid of rejection that he will probably withdraw in a group setting. While in the long run Mr. Sample needs group therapy to enhance social skills, he may initially require much individual work to prepare him for group involvement. Due to Mr. Sample's level of interpersonal suspicion and mistrust, therapists must slowly approach him and build rapport. Constant checks on how Mr. Sample construes situations are necessary as Mr. Sample projects his own feelings onto others. He must be made aware of this, as well as learn how his own behavior sets up negative reactions. Due to his level of dependency, rebelliousness, and/or need for attention, Mr. Sample is most likely to respond to peer feedback. Insight-oriented technique may help Mr. Sample understand and deal with troubling Family of Origin issues as much maladaptive behavior is in part based on emotional conflicts rooted in his past. Insight-oriented techniques should be used to help him resolve underlying emotional conflicts and habitual self-defeating behavior patterns. Significant environmental support and external structure are vital as Mr. Sample needs external restraints to deter maladaptive behavior. Liaison between Mr. Sample's probation/parole officer, family, AA sponsor, and/or employer is essential. As it is likely that Mr. Sample follows peers into maladaptive behavior, he must be empowered to independence. Development of a positive peer group is essential. As Mr. Sample blames others for his problems, therapists should encourage him to be responsible and accountable for his actions and not allow him to fall into Victimstance. High levels of anxiety are reported that may require Mental Heath evaluation/treatment if they are clinically seen. Stress management techniques and alternate ways of coping with anxiety and anxiety producing situations should be taught. Mr. Sample needs to learn anger control techniques. It is essential that Mr. Sample not be positively reinforced for covert or overt aggression. He must become aware of the negative impact of anger on his life to increase motivation to change. Cognitive Behavioral anger control technique in conjunction with Mr. Sample being taught prosocial, less aggressive ways of meeting his needs is necessary if he is to give up violence as a coping technique. Mood stabilizing medications may be indicated if biological components to Mr. Sample's aggression are suspected. As he experiences much anger, work on how to detach from and reframe anger once it is evoked is important. As much of Mr. Sample's anger may be due to over sensitivity to criticism, a stress inoculation approach coupled with self-esteem work may prove helpful. Mr. Sample needs to put more effort into constricting angry feelings. Mr. Sample needs to put more effort into dealing with angry feelings that he experiences rather than acting out on them. Specific treatment for Post Traumatic Stress Disorder is needed if clinically seen. Mr. Sample needs to learn to regulate his moods through use of Cognitive Behavioral techniques and/or medication. AODA use may be a cause of Mr. Sample's moodiness, though conversely, AODA use may be an attempt to self-medicate his emotional lability. Mr. Sample needs to increase impulse control and learn to see his feelings as "red flags" that call for problem solving rather than as imperatives upon which he must act. Use of Cognitive Behavioral techniques to increase cognitive mediation, teaching problem-solving skills, use of imagery and role-playing, frustration/stress inoculation training, and keeping journals to discover impulse triggers are suggested. A Cognitive Behavioral approach to teach Mr. Sample how to acknowledge and then detach from his feelings is necessary since he is prone to acting directly on emotions without thinking. Mr. Sample needs education about the nature of emotions and must learn ways of not immediately responding once feelings arise. Signs of substance abuse or proneness to abuse exist which may require AA or educational programming. Signs of substance dependence exist which require professional intervention. The reason for Mr. Sample's lack of normal sexual drives and interests needs to be assessed. Remedial education, social and heterosexual skill training and self-esteem work may be required to heighten attraction to appropriate sexual outlets. Stepwise positive interaction with sexually appropriate partners is indicated. If Mr. Sample's low sexual interest is due to personality factors such as a Schizoid personality disorder, it is unrealistic to expect that Mr. Sample will increase his sexual attraction to age appropriate partners. As Mr. Sample reports engaging in an extremely limited range of sexual practices, the effects of this on his sexual adjustment should be evaluated. Mr. Sample reports having very conservative and traditional sexual values. The impact of this on his life should be established. As a high degree of body dissatisfaction is reported, work to increase body image is necessary. This may include behavioral programs to increase positive health habits including diet, exercise and hygiene, as well as psychotherapy to facilitate self-acceptance. Mr. Sample reports such dissatisfaction with his sex life that further specific assessment and treatment are indicated. Sex education is essential as Mr. Sample's lack of knowledge of sexual functioning and behavior may contribute to his sexual acting out. Variables: SHIPLEY INSTITUTE OF LIVING SCALE: * VOC - 14 AB - 28 WAIS-III MATRIX REASONING SUBTEST: * MATRIX - 11 MILLON CLINICAL MULTIAXIAL INVENTORY: * V - 0 DISCLS - 89 DESIRE - 55 DBASE - 70 * SCH - 53 AVD - 72 DEPSIV - 67 DEPND - 85 * HIS - 41 NAR - 39 ANT - 78 AGR - 69 * OBSV - 39 PAG - 78 SDEF - 74 SCHTYP - 65 * BRDL - 70 PARA - 81 ANXTY - 86 SOM - 58 * MANIC - 65 DEPR - 70 ALCH - 81 DRUG - 63 * PTSD - 69 TGHTDIS - 42 MAJDEP - 57 DEL - 33 SASSI-3: * FVA - 17 FVOD - 5 SYM - 9 OAT - 7 * SAT - 3 FAMLY - 7 DEF - 3 SAM - 8 * RAP - 0 STATE-TRAIT ANGER EXPRESSION INVENTORY: * SANG - 64 SANGF - 70 SANGV - 66 SANGP - 54 * TANG - 72 TANGT - 54 TANGR - 78 AXI - 42 * AXO - 87 ACI - 22 ACO - 67 AXINDEX - 76 JESNESS INVENTORY: * SMAL - 66 VALUES - 44 IMAT - 72 AUTISM - 51 * ALIEN - 66 ASOCIAL - 62 AA - 54 AP - 54 * CFM - 67 CFC - 62 MP - 88 NA - 75 * NX - 65 SE - 58 CI - 22 DEROGATIS SEXUAL FUNCTIONING INVENTORY: * SINF - 43 SEXP - 23 SDRIV - 42 SATT - 22 * SROLE - 38 SFANT - 40 SBODY - 23 SSATIS - 32 MMPI-2 VALIDITY SCALES: * QUES - 0 L - 53 F - 65 FB - 63 * K - 51 TRIN - 62 TF - 1 VRIN - 55 MMPI-2 CLINICAL SCALES: * HS - 64 D - 59 HY - 42 PD - 67 * MF - 73 PA - 72 PT - 83 SC - 58 * MA - 66 SI - 67 MMPI-2 SUBTLE/OBVIOUS SCALES: * DOBVIOUS - 58 DSUBTLE - 54 HYOBVIOU - 45 HYSUBTLE - 52 * PDOBVIOU - 75 PDSUBTLE - 61 PAOBVIOU - 87 PASUBTLE - 32 * MAOBVIOU - 64 MASUBTLE - 51 MMPI-2 HARRIS LINGOES SUBSCALES: * D1 - 64 D2 - 37 D3 - 67 D4 - 62 * D5 - 62 HY1 - 51 HY2 - 32 HY3 - 57 * HY4 - 62 HY5 - 40 PD1 - 65 PD2 - 68 * PD3 - 64 PD4 - 67 PD5 - 77 PA1 - 76 * PA2 - 62 PA3 - 43 SC1 - 45 SC2 - 43 * SC3 - 54 SC4 - 23 SC5 - 56 SC6 - 45 * MA1 - 75 MA2 - 62 MA3 - 59 MA4 - 78 * SI1 - 64 SI2 - 59 SI3 - 68 MMPI-2 SUPPLEMENTARY SCALES: * A - 73 R - 43 ES - 38 MACR - 66 * OH - 58 DO - 65 RE - 32 MT - 68 * GM - 15 GF - 67 PK - 77 PS - 78 * APS - 68 DY - 88 MDS - 85 ST - 58 * REL - 82 PR - 74 SOC - 67 MOR - 56 * PHO - 52 CN - 67 ORG - 22 PSY - 51 * HOS - 68 HYP - 55 MMPI-2 CONTENT SCALES: * ANX - 75 FRS - 70 FRS1 - 68 FRS2 - 73 * OBS - 54 DEP - 62 DEP1 - 48 DEP2 - 54 * DEP3 - 52 DEP4 - 66 HEA - 65 HEA1 - 47 * HEA2 - 67 HEA3 - 58 BIZ - 46 BIZ1 - 56 * BIZ2 - 44 ANG - 67 ANG1 - 69 ANG2 - 62 * CYN - 68 ASP - 68 TPA - 41 LSE - 83 * SOD - 67 FAM - 88 WRK - 72 TRT - 42 * SEX - M |
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